Model Prognostik Jangka Pendek untuk Pasien Intracerebral Hemorrhage Non-Traumatik dengan Menggunakan Kombinasi FOUR Score, FUNC Score dan ICH Score

Abstract

Background: Non-traumatic intracerebral hemorrhage (ICH) is acute spontaneous bleeding into the brain parenchyma. Currently, the Functional Outcome in Patients with Primary Intracerebral Hemorrhage (FUNC) score, the Full Outline of UnResponsive (FOUR) score and Intracerebral Hemorrhage (ICH) score are used to predict the outcome of patients with non-traumatic ICH. The high mortality of non-traumatic ICH patients makes the scoring system very important as a predictive model on prognosis of mortality for these patients. Purpose: To present short-term prognostic model for non-traumatic ICH patients based on the combination of FUNC Score, FOUR Score and ICH at H. Adam Malik General Hospital Medan Method: This study was a prospective observational cohort study, consisted of 40 non-traumatic ICH patients admitted to neurology ward and Intensive Care Unit of H. Adam Malik General Hospital – Medan, from March to September 2023. All eligible subjects will be observed for 30 days to evaluate the expected short-term mortality. Statistical analysis was performed using the nonparametric test (Chi square test). Cut-off points for the FUNC, FOUR dan ICH scores will be evaluated using the Receiver Operating Characteristics (ROC) to determine the Area Under the Curve (AUC). Multivariate logistic regression analyses were performed. p value of < 0.05 was considered significant. Results: Out of 40 non-traumatic ICH patients, 18 patients survived throughout the follow up. The mean age of the subjects was 55.61+13.07 years. A significant correlation between the FUNC score, FOUR scores and ICH score on short-term mortality in non-traumatic ICH patients was found, each with p-value of <0.001. Meanwhile, the cut-off point for short-term mortality for the FUNC score was found at 8.5, for the FOUR score at 11.5 and for the ICH score at 2.5. The result of multivariate logistic regression analysis was not statistically significant (p > 0.05). Conclusion: There was a significant positive correlation between each of the FUNC score, FOUR score and ICH score in predicting short-term mortality in non-traumatic ICH patients. However, FOUR score, FUNC score and ICH score cannot be combined to predict mortality in non-traumatic ICH patients.